When suturing a surgical incision, a surgeon generally attempts to close the incision in a manner that minimizes scarring, hernias, and the likelihood of infection. A common technique is to anchor a suture on either side of an incision within the relatively tough fascial layer.
However, placing a suture through this inner tissue layer without damaging surrounding tissue and organs may be difficult under the best of circumstances and almost impossible where the patient is very obese and/or the incision is very small. A surgeon may have difficulty reaching into the incision and even more difficulty seeing the surrounding tissue beyond his fingers. Additionally, a suture needle that pierces tissue from an outer tissue layer toward the interior of the body may accidentally puncture a blood vessel or an organ.
A curved or inverted needle can provide a means for penetrating the fascial layer from beneath, thereby reducing the risk of accidental puncture. An inverted needle attached to an elongated shaft can be inserted into a small and/or deep incision without blocking the surgeon's view, simplifying the task of puncturing the fascial layer from beneath in the optimum location.
However, an inverted needle presents new difficulties once the suture is placed, since the upwardly-directed point tends to snag tissue while being withdrawn and relocated. Attempts to mitigate this problem usually involve retracting the needle into a hollow shaft or masking the tip of the needle with block of material, either by sliding the needle into the block or the block onto the needle.
In any case, both a hollow shaft of sufficient diameter to accommodate an internal mechanism and a mask large enough to cover a needle tip spaced any distance from the shaft can obstruct the surgeon's view and impair his ability to move and place the needle.
What is needed is a surgical device that provides an inverted suture needle that a surgeon can easily mask and unmask while identifying a desirable location within the body, while moving the needle to that location, while placing a suture, and while subsequently withdrawing the device entirely. The needle and supporting apparatus should minimize the bulk of any material inserted into an incision. Once the suture is placed, the device should allow the surgeon to quickly withdraw the apparatus without concern for tissue damage.